WO2023181296A1

WO2023181296A1 - Surgery assistance device

Info

Publication number: WO2023181296A1
Application number: PCT/JP2022/014134
Authority: WO
Inventors: 円朗山本
Original assignee: リバーフィールド株式会社
Priority date: 2022-03-24
Filing date: 2022-03-24
Publication date: 2023-09-28
Also published as: JP7360761B1; JPWO2023181296A1; CN117881359A

Abstract

The present invention comprises: a plurality of connecting arms; a holder supported by the connecting arms; and a fixed base to which the connecting arms are connected. The fixed base has a base body in which prescribed parts are arranged, and a clamper at least a part of which protrudes from the base body and which can be fixed to an operating table. The position of the clamper in the up-down direction relative to the base body is changeable. Due to this configuration, the position of the clamper in the up-down direction relative to the base body can be changed, in a state where the fixed base is fixed to the operating table or fixed to a stand.

Description

surgical support equipment

The present invention relates to the technical field of a surgical support device having a fixed base that can be fixed to a surgical table.

In recent years, surgical operations using surgical support devices have become popular. Such a surgical support device includes a plurality of connecting arms that are rotatably or rotatably connected in order. Some have a holder connected to them to hold the ingredients. As surgical tools, endoscopes, forceps, etc. are used depending on the type and situation of the surgery.

In a surgical support device, when a plurality of connecting arms are pivoted or rotated in a predetermined direction, the position and posture of the surgical tool are changed in accordance with the movement of the connecting arms, and the surgical tool held in the holder performs a surgical operation. will be held.

A surgical operation using the above-mentioned surgical support device is generally performed by an operator (doctor) remotely operating the surgical support device installed in the operating room using a master-slave method. When performing such a surgical operation, a pivot point is set as a reference point for the position and posture of the surgical instrument.

The pivot point is a position that approximately corresponds to a port formed in the patient's body cavity into which a surgical tool is inserted, and when a trocar is used, it approximately corresponds to the position of the trocar. Therefore, when a surgical instrument is inserted into a patient's body cavity, the position and posture of the surgical instrument are controlled so that a part of the surgical instrument always passes through the pivot point; This prevents the occurrence of a load on tissues near the patient's body surface, thereby ensuring safety.

Some of the surgical support devices described above are used while being fixed to the operating table with a clamper during surgery (see, for example, Patent Document 1 and Patent Document 2). Further, such a surgical support device may be fixed to a stand (carriage) by a clamper and can be used with the stand installed around the operating table.

JP2021-78781A Japanese Patent Application Publication No. 2002-191545

By the way, in surgery, there is a desirable height of the surgical support device used depending on the patient's body shape, surgical method, etc., and using the surgical support device at such a desirable height increases usability and improves the surgical performance. is carried out appropriately and promptly.

Additionally, when the base body is used with the base body fixed to the stand, each part of the surgical support device does not interfere with the operating table, and the stand is used as close to the operating table as possible, increasing usability. It is also desired that

Therefore, it is an object of the present invention to improve the usability of the surgical support device in both the state in which it is fixed to a surgical table and the state in which it is fixed to a stand.

The surgical support device according to the present invention includes a plurality of connecting arms, a holder supported by the connecting arms, and a fixed base to which the connecting arms are connected, and the fixed base is a base in which predetermined parts are arranged. It has a main body and a clamper, at least a portion of which protrudes from the base main body and can be fixed to a surgical table, and the position of the clamper in the vertical direction with respect to the base main body can be changed.

As a result, the position of the clamper in the vertical direction relative to the base body can be changed in either the state where it is fixed to the operating table or the state where it is fixed to the stand.

According to the present invention, the position of the clamper in the vertical direction with respect to the base body can be changed in both the state in which the fixed base is fixed to the operating table and the state in which it is fixed to the stand, so that the clamper is fixed to the operating table. The surgical support device can be set at the optimal height when the surgical support device is being used, and the clamper can be removed when it is fixed to the stand so that it does not interfere with the operating table, improving usability in any situation. can be achieved.

An embodiment of the surgical support device of the present invention is shown together with FIGS. 2 to 9, and this figure is a schematic perspective view showing the operating state of the surgical support device. It is a schematic perspective view of a surgical support device. FIG. 2 is a perspective view showing a state in which the surgical support device is installed on a stand. FIG. 3 is a sectional view showing a state before the clamper is fixed to the base body. It is a perspective view of a clamper. FIG. 6 is a perspective view of the clamper as seen from a different direction from FIG. 5; FIG. 3 is a cross-sectional view showing a state in which the clamper is being fixed to the base body. FIG. 3 is a sectional view showing a state in which the clamper is fixed to the base body. FIG. 2 is an exploded perspective view showing a separator and an adapter to which a surgical tool is attached.

Hereinafter, embodiments for implementing the surgical support device of the present invention will be described with reference to the accompanying drawings.

Note that the front, rear, top, bottom, left and right directions shown below are for convenience of explanation, and the implementation of the present invention is not limited to these directions.

<Schematic configuration of surgical support equipment, etc.>
First, the schematic configuration of the surgical support device 1 and the like will be described (see FIGS. 1 and 2).

An operating table 100 is installed in the operating room, and a patient 200 is lying on the operating table 100, for example, in a supine state. A fixing rail 100a is provided on the side of the operating table 100. A port 202 is formed in the body cavity 201 of the patient 200, for example, the abdominal wall 201a. A portion of a surgical tool, which will be described later, is inserted into the port 202 when a surgical operation is performed. Port 202 is a small hole into which a portion of a surgical tool is inserted.

The surgical support device 1 has a device main body 2 and a holder 3. Inside the device main body 2, for example, one electric motor (not shown) and a plurality of pneumatic actuators (not shown) are arranged.

The device main body 2 has a fixed base 4 that can be fixed to the operating table 100 and an arm body 5 connected to the fixed base 4.

The fixed base 4 includes a substantially rectangular parallelepiped-shaped base body 6 in which various predetermined mechanisms are provided, a pedestal 7 rotatably supported by the base body 6, and a clamper whose parts except a part protrude from the base body 6. 8. The fixed base 4 is rotatably supported by a pedestal 7 about an axis S1 extending perpendicularly to the base body 6 as a fulcrum. The pedestal 7 is rotated relative to the fixed base 4 by, for example, the driving force of an electric motor.

The arm body 5 has a first connecting arm 9, a second connecting arm 10, and a third connecting arm 11. Note that the number of connecting arms in the arm body 5 is not limited to three, and may be a plurality of connecting arms, and may be two or four or more.

One end of the first connecting arm 9 in the longitudinal direction is provided as a first connecting portion 9a, and the other end in the longitudinal direction is provided as a second connecting portion 9b. The first connecting arm 9 has a first connecting portion 9a connected to the pedestal 7, and is rotatable relative to the pedestal 7 about a horizontally extending axis S2 as a fulcrum. The first connecting arm 9 is rotated relative to the base 7 by, for example, a pneumatic actuator operated by compressed air supplied from a compressor.

The second connection arm 10 has one end in the longitudinal direction provided as a first connection part 10a, and the other end in the longitudinal direction provided as a second connection part 10b. The second connecting arm 10 has a first connecting part 10a connected to a second connecting part 9b of the first connecting arm 9, and rotates with respect to the first connecting arm 9 about an axis S3 extending in the horizontal direction. be made movable. The second connecting arm 10 is rotated relative to the first connecting arm 9 by a pneumatic actuator operated by compressed air supplied from a compressor, for example.

One end of the third connecting arm 11 in the longitudinal direction is provided as a first connecting part 11a, and the other end in the longitudinal direction is provided as a second connecting part 11b. The second connecting portion 11b is composed of, for example, two arm portions. In the third connecting arm 11, the first connecting part 11a is connected to the second connecting part 10b of the second connecting arm 10, and the second connecting arm 10 is connected to the axis S4 extending in a direction orthogonal to the axis S3 as a fulcrum. Rotatable with respect to. The third connecting arm 11 is not rotated by an external driving force such as the driving force of an electric motor or a pneumatic actuator, and is not rotated by its own weight or other forces such as the first connecting arm 9 or the second connecting arm 10. This is a part that rotates freely according to the movement.

The holder 3 is rotatably supported (connected) to the second connecting portion 11b of the third connecting arm 11. The holder 3 is rotatable relative to the third connecting arm 11 about an axis S5 extending in a direction perpendicular to the axis S4. The holder 3 is not rotated by an external driving force such as the driving force of an electric motor or a pneumatic actuator, but is rotated by its own weight, the first connecting arm 9, the second connecting arm 10, the third connecting arm 11, etc. It is a part that performs a free rotational movement that rotates in response to other movements.

The holder 3 has a base cylinder part 12 which is partially rotatable and is not rotated, a rotating part 13 rotatably supported by the base cylinder part 12, and a connecting cylinder part 14 attached to the base cylinder part 12. (See Figure 3).

A part of the rotating part 13 is located inside the base cylindrical part 12 and the connecting cylindrical part 14, and a rear end part is located on the rear side of the base cylindrical part 12. The rotating part 13 is rotatable relative to the base cylinder part 12 and the connecting cylinder part 14 in a direction around an axis S6 orthogonal to the axis S5. The rotating part 13 is rotatable by, for example, a pneumatic actuator operated by compressed air supplied from a compressor, and can also be rotated manually.

A locking mechanism (not shown) is arranged inside the holder 3. A lock release button 14a is arranged on the connecting cylinder portion 14. A switching button 13a is arranged at the rear end of the rotating section 13. The switching button 13a has a function of switching the driving force for rotating the rotating section 13.

In the holder 3, when the switching button 13a is operated, the rotating part 13 is manually rotatable. On the other hand, when the switching button 13a is not operated, the rotating part 13 is made rotatable by the driving force of the pneumatic actuator.

As mentioned above, in the surgical support device 1, each part is configured to be rotatable or rotatable about six axes from the axis S1 to the axis S6, so the orientation and position of the surgical tool held in the holder 3 It has a high degree of freedom (posture) and can perform surgery quickly and with high precision. Particularly, since free rotational or rotational movement is performed on the axes S4 and S5 and the axes S4 and S5 are perpendicular to each other, when the direction or position of the surgical instrument inserted into the port 202 is changed or when the patient 200 When the direction or position of the port 202 is changed due to breathing conditions or the like, the load on tissues near the body surface of the patient 200 can be reduced.

In the surgical support device 1, rotation of the arm body 5 on the axis S1 at the farthest position from the surgical tool is performed by the driving force of the electric motor, and the axis S2 and the axis S3 at a position closer to the surgical tool than the axis S1 are rotated. The rotation or rotation about the axis S6 is performed by the driving force of the pneumatic actuator.

Therefore, the arm body 5 is operated at a position close to the surgical instrument by the driving force of the pneumatic actuator, which has a smaller load on the patient 200 than the driving force of the electric motor, further reducing the load on the tissues near the body surface of the patient 200. be able to.

Furthermore, since the arm body 5 is rotated or pivoted at more locations due to the driving force of the pneumatic actuator than the locations where the arm body 5 is rotated due to the driving force of the electric motor, the tissue near the body surface of the patient 200 is It is possible to reduce the load.

Note that in the surgical support device 1, an ultrasonic motor such as a piezoelectric motor capable of highly accurate positioning may be used instead of the electric motor or pneumatic actuator. By using the ultrasonic motor, it is possible to save power and downsize the surgical support device 1.

<Specific configuration of fixed base, etc.>
The specific structure of the fixed base 4 will be described below (see FIGS. 2 to 8).

As described above, the fixed base 4 includes the base body 6, the pedestal 7, and the clamper 8 (see FIGS. 2 and 3).

The base main body 6 has an outer casing 15 formed in a substantially rectangular parallelepiped shape and various predetermined mechanisms arranged inside the outer casing 15. 18, a lower surface portion (not shown), and a rear surface portion (not shown) (see FIGS. 3 and 4).

A plurality of positioning holes 16a are formed in the front part 16. For example, three positioning holes 16a are formed vertically apart from each other. A plurality of arrangement holes 16b are formed in the front part 16. The arrangement hole 16b is formed on the outer side and slightly below the positioning hole 16a in the left-right direction. Therefore, three placement holes 16b are formed on each side of the positioning hole 16a.

In the base body 6, the number of positioning holes 16a is arbitrary as long as it is plural, and one arrangement hole 16b is formed on each side of each positioning hole 16a.

The base body 6 is provided with fixing protrusions 19 that protrude outward from a pair of side surfaces 18, respectively. The fixing protrusion 19 is provided at a position near the upper end of the side surface portion 18.

The base body 6 is provided with a locking member 20 that is partially inserted into the placement hole 16b (see FIG. 4). The locking member 20 is formed into a cylindrical shape with its axial direction extending in the front-rear direction, and its front end is inserted into the arrangement hole 16b. A space inside the locking member 20 is formed as an insertion hole 21. An inclined surface whose diameter increases toward the rear is formed in the axially intermediate portion of the inner circumferential surface of the locking member 20, and this inclined surface serves as a locking engagement portion 20a. The insertion hole 21 is formed as a displacement regulating part 21a in which a portion on the front side of the locking engagement portion 20a has a smaller diameter than a portion on the rear side.

An air suction pipe (not shown) protrudes from the rear surface of the base body 6. The air suction pipe is connected to the compressor via a suction tube. Therefore, compressed air is supplied to the inside of the fixed base 4 from the compressor. The compressed air supplied to the inside of the fixed base 4 passes through the inside of the fixed base 4 to the inside of the arm body 5, and is driven to rotate or rotate the first connecting arm 9, the second connecting arm 10, and the holder 3. Used as a force.

The clamper 8 has a clamp base 22, a lower clamp portion 23, a clamp lever 24, and a pair of locked members 25 (see FIGS. 4 to 6).

The clamp base 22 includes a substantially rectangular frame portion 26 that is penetrated from front to back, an upper clamp portion 27 that protrudes forward from the upper end of the frame portion 26, and an upper clamp portion 27 that extends forward from both left and right sides of the frame portion 26, respectively. a pair of protruding support plate parts 28; a pair of mounting protrusions 29 protruding outward in the left-right direction from a portion extending from the rear end of the frame-shaped part 26 to the rear end of the support plate part 28; have.

A screw hole (not shown) is formed in the upper clamp part 27 and extends vertically. An upper insertion recess 27a that is open downward and laterally is formed at a position near the front end of the upper clamp portion 27.

The front end of the support plate part 28 is located rearward than the front end of the upper clamp part 27. The support plate portion 28 is provided with a stopper shaft 28a that projects inward in the left-right direction.

A shaft insertion hole 30 is formed in the mounting protrusion 29, and the shaft insertion hole 30 consists of a large diameter portion 31 located on the front side and a small diameter portion 32 located on the rear side (FIG. 4). reference). The mounting protrusion 29 has an annular stepped surface 33 facing forward at the boundary between the large diameter portion 31 and the small diameter portion 32 .

The clamper 8 is provided with a positioning pin 34 that projects rearward from the frame portion 26 (see FIG. 6).

The lower clamp part 23 is rotatably supported by a pair of support plate parts 28 below the upper clamp part 27. The lower clamp portion 23 has a main body portion 35 located between a pair of support plate portions 28 and a pair of supported shaft portions 36 protruding outward from the main body portion 35 in the left-right direction. The main body portion 35 is formed in a flat shape and has a lower insertion recess 35a that is open upwardly and laterally at the front end. The rear end portion of the main body portion 35 is provided as a pressed portion 35b. The lower clamp portion 23 is rotatable with respect to the clamp base 22 with the supported shaft portion 36 as a fulcrum as the supported shaft portion 36 is supported by the pair of support plate portions 28 .

The supported shaft portion 36 protrudes from a portion between the lower insertion recess 35a and the pressed portion 35b. A coil portion 37a of a torsion coil spring 37 is supported by the supported shaft portion 36. One arm portion 37b of the torsion coil spring 37 is engaged with the support plate portion 28, and the other arm portion 37c is engaged with the main body portion 35. Therefore, the lower clamp part 23 is biased by the biasing force of the torsion coil spring 37 in the direction in which the pressed part 35b approaches the upper clamp part 27. The rotation of the lower clamp portion 23 in the direction urged by the torsion coil spring 37 is restricted by the main body portion 35 coming into contact with the stopper shaft 28a of the support plate portion 28.

The clamp lever 24 is composed of a rotational operation section 24a and a screw shaft section 24b, and the screw shaft section 24b projects downward from the rotation operation section 24a. A screw groove is formed on the outer peripheral surface of the screw shaft portion 24b.

The clamp lever 24 is screwed into the screw hole with the screw shaft portion 24b passing through the upper clamp portion 27, and the lower end of the screw shaft portion 24b is in contact with the pressed portion 35b of the main body portion 35 from above. There is. The pressed portion 35b of the main body portion 35 is pressed against the lower end of the helical shaft portion 24b by the urging force of the torsion coil spring 37. Therefore, when the rotation operating portion 24a of the clamp lever 24 is manually rotated, the threaded groove threaded into the screw hole is sent in the axial direction of the threaded shaft portion 24b, and the threaded portion 24b is rotated by the rotation operating portion 24a. The lower clamp portion 23 is rotated with respect to the clamp base 22 using the supported shaft portion 36 as a fulcrum.

The locked member 25 is formed into a shaft shape that extends back and forth (see FIG. 6). In the locked member 25, approximately half of the front side excluding the front end is provided as a first insertion section 38, and approximately half of the rear side thereof is provided as a second insertion section 39. The diameter of the first insertion portion 38 is larger than the diameter of the second insertion portion 39, and is one size smaller than the diameter of the large diameter portion 31 of the shaft insertion hole 30 formed in the mounting projection 29. The diameter of the second insertion portion 39 is one size smaller than the diameter of the small diameter portion 32 of the shaft insertion hole 30 formed in the mounting protrusion 29, and is approximately the same as the diameter of the displacement regulating portion 21a of the locking member 20. .

A plurality of lock balls 40 are supported in a portion near the rear end of the second insertion portion 39 so as to be displaceable and spaced apart in the circumferential direction (see FIG. 4). The locking ball 40 is displaceable in the radial direction of the second insertion section 39, and is between a protruding position where it protrudes the most from the second insertion section 39 and a retracted position where it is most drawn into the inside of the second insertion section 39. Displaced. The locking ball 40 is biased in a direction from the retracted position toward the ejected position by a biasing spring (not shown) disposed inside the second insertion portion 39 .

In the fixed base 4 configured as described above, the clamper 8 is attached to the base body 6 in the following manner (see FIGS. 4, 7, and 8).

First, the clamper 8 is positioned with respect to the base body 6 by inserting the positioning pin 34 into the positioning hole 16a of the base body 6. At this time, the positioning pin 34 is inserted into one of the positioning holes 16a formed vertically apart from each other, so that the clamper 8 can be attached to the base body 6 at a desired height.

When the clamper 8 is positioned on the base body 6, the shaft insertion hole 30 formed in the mounting protrusion 29 is aligned with the insertion hole 21 of the locking member 20 from the front to the rear (see FIG. 4).

Next, the pair of locked members 25 are sequentially inserted into the shaft insertion hole 30 formed in the mounting protrusion 29 and the insertion hole 21 of the locking member 20, respectively. When the locked member 25 is inserted into the insertion hole 21 from the shaft insertion hole 30 and the second insertion part 39 is positioned in the displacement restriction part 21a of the insertion hole 21, the lock ball 40 in the protruding position moves into the displacement restriction part. The displacement toward the protruding position is regulated by 21a, and the displacement toward the retracted position is performed against the biasing force of the biasing spring (see FIG. 7). When the locked member 25 is inserted further into the shaft insertion hole 30, the rear surface of the first insertion portion 38 comes close to or comes into contact with the stepped surface 33 of the shaft insertion hole 30, and the locking ball 40 moves into the displacement regulating portion. 21a, the restriction on displacement is released, and by the biasing force of the biasing spring it is displaced toward the protruding position and engaged with the locking engagement portion 20a (see FIG. 8). Therefore, the clamper 8 is locked to the base body 6 by the locking member 20.

When the locking ball 40 is positioned behind the displacement regulating portion 21a and engaged with the locking engaging portion 20a, the displacement of the locking ball 40 is transmitted to the operator's fingers, and the operator can use the clamping force of the locking member 20 to 8 is recognized to have been completely locked to the base body 6. Further, when the lock ball 40 is engaged with the locking engagement portion 20a, a sound may be generated as the lock ball 40 is displaced. It is recognized that locking of the clamper 8 to the base body 6 by the clamper 20 is completed.

As described above, in the surgical support device 1, the two lockable members 25 are provided on the clamper 8, and the two lockable members 25 are respectively engaged with the base body 6 to lock the clamper 8 to the base body 6. A member 20 is provided.

Therefore, even when one locked member 25 is disengaged from the locking member 20, the other locked member 25 is engaged with the locking member 20 and the clamper 8 is held on the base body 6. It is possible to prevent the clamper 8 from accidentally falling off from the base body 6.

Further, the locking member 20 is formed in a cylindrical shape, the locked member 25 is formed in a shaft shape, and the clamper 8 is locked to the base body 6 by inserting the locked member 25 into the locking member 20 to a predetermined position. Ru.

Therefore, the clamper 8 is locked to the base body 6 by inserting the locked member 25 into the locking member 20, so that the clamper 8 can be locked to the base body 6 easily and reliably.

On the other hand, to remove the clamper 8 from the base body 6, the member to be locked 25 is pulled out from the insertion hole 21 and the shaft insertion hole 30, the engagement of the locking ball 40 with the locking engagement portion 20a is released, and the positioning pin 34 is removed from the locking engagement portion 20a of the locking ball 40. This can be done by pulling it out from the positioning hole 16a.

Note that a threaded groove portion is formed in a part of the inner circumferential surface of the locking member 20 and a part of the outer circumferential surface of the locked member 25, and the threaded groove portions are screwed together. 25 may be rotated with respect to the locking member 20, and the locked member 25 may be moved in the axial direction with respect to the locking member 20.

<Separator configuration, etc.>
Next, the configuration of the separator 41 attached to the holder 3 will be explained (see FIGS. 1, 2, and 9).

A separator 41 is removably attached to the holder 3. The separator 41 includes a substantially disk-shaped mounting portion 42, an insertion portion 43 protruding from one surface of the mounting portion 42 in the thickness direction, and a pair of engaging portions 44 protruding from the other surface of the mounting portion 42 in the thickness direction. It has The separator 41 is attached to the holder 3 with the insertion portion 43 inserted into the front end of the holder 3 and locked by the locking mechanism. The separator 41 can be unlocked from the holder 3 by operating the lock release button 14a of the holder 3.

An adapter 45 is detachably attached to the separator 41. The adapter 45 is made up of, for example, a first member 46 and a second member 47 coupled at the top and bottom, and is provided as an attached part 48 whose rear end is engaged with and attached to the separator 41.

A surgical tool 80 is attached to the adapter 45. The surgical tool 80 is provided, for example, as a scope unit having an endoscope, and includes a shaft portion 81 in which a plurality of lenses are arranged, a head portion 82 coupled to one end of the shaft portion 81, and an intermediate portion between the shaft portion 81. It has a light guide 83 coupled to the section. An image sensor (not shown) is arranged inside the head section 82 .

Cables (not shown) serving as signal lines and power lines are connected to the head portion 82, and a ride guide cable (not shown) for guiding light is connected to the light guide 83.

The surgical tool 80 is held by the adapter 45 by having the head portion 82 sandwiched between the first member 46 and the second member 47 from above and below. The adapter 45 holding the surgical tool 80 is attached to the separator 41 by inserting the attachment portion 48 between the pair of engagement portions 44 and engaging the attachment portion 42 and the engagement portion 44 . Therefore, the surgical tool 80 is held in the holder 3 via the adapter 45 and separator 41.

At least the distal end of the shaft portion 81 of the surgical tool 80 is inserted into the body cavity 201 through a port 202 formed in the patient 200. When the distal end of the shaft portion 81 is inserted into the body cavity 201, illumination light is emitted from the distal end of the shaft portion 81, and the state inside the body cavity 201 is photographed by the imaging device.

<Stand configuration, etc.>
Next, the configuration of the stand 50 to which the fixed base 4 is fixed will be explained (see FIG. 3).

In the surgical support device 1, for example, the fixed base 4 is installed on a stand 50 that can also be used as a trolley, and is transported to a sterilization room by the stand 50, where it is sterilized, transported to an operating room, and used in a surgery. made possible.

The stand 50 has a chassis 52 on which a plurality of wheels 51 are supported, a connection base 53 connected to the chassis 52, and a device fixing part 54 connected to the connection base 53. The connection base 53 and the device fixing part 54 are located above the vehicle chassis 52, and the position of the device fixing part 54 can be adjusted in the vertical direction with respect to the connection base 53. Therefore, in the stand 50, the height of the surgical support device 1 can be changed by adjusting the height of the device fixing portion 54.

The upper part of the device fixing part 54 is bent rearward with respect to the lower part, and the rearward bent part is a handle part 54a that is grasped by the user (carrier). The device fixing portion 54 is provided with a pair of fixing arm portions 54b that protrude downward and forward from the handle portion 54a and are spaced apart from each other in the left and right directions.

The fixing base 4 is fixed to the stand 50 by, for example, attaching fixing members 55 to a pair of fixing protrusions 19 that protrude outward from the side surface 18, and fastening the fixing members 55 to the fixing arm portions 54b. This is done by fastening with the tool 56.

When the fixed base 4 is fixed to the stand 50 and the surgical support device 1 is installed on the stand 50, the clamper 8 is positioned on the opposite side of the handle portion 54a with the base body 6 interposed therebetween.

<Usage status of surgical support equipment, etc.>
Next, the usage status of the surgical support device 1 will be explained (see FIGS. 1 and 3).

The surgical support device 1 can be used during surgery with the fixed base 4 fixed to the fixing rail 100a of the operating table 100 by the clamper 8 (see FIG. 1).

As described above, the clamper 8 has the positioning hole 16a and the insertion hole 21 with different heights, so that the positioning pin 34 and the locked member 25 are inserted into either the positioning hole 16a or the insertion hole 21, respectively. The clamper 8 is attached to the base body 6 at an appropriate height and locked.

The clamper 8 is fixed to the fixing rail 100a by rotating the clamp lever 24 in one direction while the fixing rail 100a is inserted between the upper clamp part 27 and the lower clamp part 23. be exposed. When the clamp lever 24 is rotated, the lower clamp part 23 is rotated with respect to the clamp base 22 in a direction in which the lower insertion recess 35a approaches the upper clamp part 27 using the pair of supported shaft parts 36 as fulcrums. . Therefore, the fixing rail 100a is inserted between the upper insertion recess 27a of the upper clamp part 27 and the lower insertion recess 35a of the lower clamp part 23, and the fixing rail 100a is inserted between the upper clamp part 27 and the lower clamp part 23. By being clamped, the fixed base 4 is fixed to the fixing rail 100a by the clamper 8.

On the other hand, by rotating the clamp lever 24 in the opposite direction to the above and rotating the lower clamp part 23, the clamper 8 is removed from the fixing rail 100a, and the fixed base 4 is fixed to the fixing rail 100a. can be canceled.

Further, as described above, the surgical support device 1 can be used even when the fixed base 4 is fixed to the stand 50 during surgery (see FIG. 3). When the surgical support device 1 is used with the fixed base 4 fixed to the stand 50, it is desirable to use the surgical support device 1 as close to the operating table 100 as possible.

In the surgical support device 1, the clamper 8 is removably attached to the base body 6, and the clamper 8 is not required when the surgical support device 1 is used with the fixed base 4 fixed to the stand 50. Therefore, in this case, it is possible to remove the clamper 8 from the base body 6 and use the surgical support device 1. Therefore, by removing the clamper 8 protruding from the base body 6, it is possible to move the surgical support device 1 and the stand 50 closer to the operating table 100.

Furthermore, when the fixed base 4 is fixed to the stand 50 during surgery, the surgical support device 1 can be used by attaching the clamper 8 to a position where it does not interfere with the operating table 100, for example, at the lowest position. It is also possible to remove the clamper 8 and use the surgical support device 1.

<Summary>
As described above, in the surgical support device 1, the fixed base 4 includes a base main body 6 in which predetermined parts can be arranged, and a clamper 8 that at least partially protrudes from the base main body 6 and is fixed to the operating table 100. The position of the clamper 8 relative to the base body 6 in the vertical direction can be changed.

Therefore, the position of the clamper 8 in the vertical direction relative to the base body 6 can be changed in both the state in which the fixed base 4 is fixed to the operating table 100 and the state in which it is fixed to the stand 50. As a result, the surgical support device 1 can be set at an optimal height when the fixed base 4 is fixed to the operating table 100, and the clamper 8 can be removed to interfere with the operating table 100 when the fixed base 4 is fixed to the stand 50. This makes it possible to improve the usability of the surgical support device 1 in any situation.

Although the above example shows that the clamper 8 is locked to the base body 6 by the locking member 20 or the like, for example, the clamper 8 may be made vertically movable relative to the base body 6 by driving a motor or the like. Good too. Further, for example, a rotary operation section having a ball screw or the like may be used, and the clamper 8 may be made vertically movable with respect to the base body 6 by manually rotating the rotation operation section.

In addition, since the clamper 8 is removably attached to the base body 6, when the base body 6 is fixed to the stand 50 with the clamper 8 removed from the base body 6 and the surgical support device 1 is used in a surgery, it is possible to perform a surgical operation. Since the clamper 8 does not interfere with the table 100, the surgical support device 1 can be used close to the surgical table 100, and the usability of the surgical support device 1 can be further improved.

In addition, when the base body 6 is fixed to the stand 50 with the clamper 8 removed from the base body 6 and the surgical support device 1 is used in a surgery, the height of the surgical support device 1 is adjusted by the height adjustment mechanism of the stand 50. It is possible to change the size depending on the body shape of the patient 200, the surgical method, etc. In addition, when using the surgical support device 1 in a surgery by fixing the clamper 8 to the fixing rail 100a of the operating table 100 with the clamper 8 attached to the base body 6, the mounting position of the clamper 8 with respect to the base body 6 may be changed. By adjusting the height of the surgical support device 1, it is possible to change the height of the surgical support device 1 depending on the body shape of the patient 200, the method of surgery, etc.

100 Operating table 1 Surgery support device 3 Holder 4 Fixed base 6 Base main body 8 Clamper 9 First connecting arm 10 Second connecting arm 11 Third connecting arm 20 Locking member 20a Lock engaging portion 25 Locked member

Claims

comprising a plurality of connecting arms, a holder supported by the connecting arms, and a fixed base connected to the connecting arms,
The fixed base has a base body in which predetermined parts are arranged, and a clamper that at least partially protrudes from the base body and can be fixed to the operating table,
A surgical support device, wherein the position of the clamper in the vertical direction with respect to the base body can be changed.
The surgical support device according to claim 1, wherein the clamper is detachable from the base body.
The clamper is provided with two locked members,
The surgical support device according to claim 2, further comprising two locking members that are respectively engaged with the locked members and lock the clamper to the base main body.
The locking member is formed in a cylindrical shape,
The locked member is formed into a shaft shape,
The surgical support device according to claim 3, wherein the clamper is locked to the base main body by inserting the locked member into the locking member to a predetermined position.